The era of compound management for obesity

Focuses on Wegovy’s cardiovascular benefit synergy

Need to treat obesity, lose weight, and manage comorbidities such as hypertension at the same time to manage obesity

Clinical benefits such as weight loss, and cardiovascular risk reduction are expected with Wegovy

Prescription limitations exist due to non-reimbursement...Novo Nordisk “looks for ways to expand access”

Wegovy (semaglutide), an obesity drug hailed as a game-changer, is seeking synergy with its cardiovascular benefits in addition to weight loss.

 

Experts say that the obesity treatment paradigm is already evolving beyond weight loss to overall health care.

 

In the future, it will be a challenge to improve access through expert review and reimbursement.

 

(from the left) Soo Lim, Professor of endocrinology and metabolism at Seoul National University Bundang Hospital, Jong Chan Yoon, Professor of Cardiology at Seoul St.

 

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Novo Nordisk held a media session on the 21st of this month to highlight the weight loss and cardiovascular disease risk reduction effects of Wegovy.

 

Wegovy is an obesity treatment that is administered once a week.

 

It is licensed in Korea as an adjunct to weight loss and weight management in patients with weight-related comorbidities.

 

In July last year, the indication was expanded to include the risk reduction of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) in overweight and obese patients with established cardiovascular disease.

 

“The 20% reduction in major adverse cardiovascular events (MACE) seen with semaglutide in adult obese patients with cardiovascular disease is a significant step forward in the treatment of obesity,” said Julie Broe Honore, Senior CMR (Clinical, Medical, and Regulatory) Director at Novo Nordisk Korea.

 

“From a clinical perspective, semaglutide is a treatment option that can be used in conjunction with diet and increased physical activity to help manage weight and reduce the risk of major cardiovascular events.” Korean experts also emphasize the importance of active treatment interventions as obesity is a chronic disease that goes beyond simple weight gain and leads to multiple metabolic and cardiovascular complications.

 

“The comorbidities of diabetic patients in Korea include hypertension (60%), kidney disease (40%), hyperlipidemia (70%), and obesity (50%),” said Dr.

 

Soo Lim, Professor of endocrinology and metabolism at Seoul National University Bundang Hospital.

 

”It is time to control multiple diseases together, and I think GLP-1 will be the best medicine to manage them all at once.”

Jong Chan Yoon, Professor of Cardiology at Seoul St.

 

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Jong Chan Yoon, MD, Professor of Cardiology at Seoul St.

 

Mary's Hospital, noted that obesity significantly increases the risk of cardiovascular disease.

 

“Cardiovascular disease is one of the leading causes of death globally, and after analyzing data from 195 countries around the world from 1990 to 2015, we found that about two-thirds of obesity-related deaths were associated with cardiovascular disease,” said Professor Yoon.

 

In the SELECT study, Wegovy demonstrated a significant 20% reduction in the risk of major cardiovascular events in the Wegovy arm compared to the placebo arm over a median follow-up of 39.8 months.

 

“The results of the SELECT study demonstrate that the treatment goals for obesity can be expanded beyond simple weight loss to include reducing the risk of major cardiovascular events,” said Professor Yoon.

 

In particular, Professor Lim emphasized that the results of the study showed that GLP-1 class drugs have greater cardiovascular benefits than other diabetes medications.

 

“When we directly compared the cardiovascular disease reduction effects of GLP-1 and SGLT2, GLP-1 showed better benefits, and in stroke, SGLT2 had no effect, but GLP-1 showed good effect,” Lim analyzed.

 

However, Wegovy, which was launched in Korea in October last year, is currently non-reimbursed and has a cost hurdle.

 

Apart from its clinical benefits, it is unclear how much it can be utilized in practice considering its cost-effectiveness.

 

Soo Lim, Professor of endocrinology and metabolism at Seoul National University Bundang Hospital.

 

In response to this, Professor Lim said, “It is good to use a lot of good drugs, but there is a limit to their use because they are not reimbursed.

 

The government needs to also take the view that severe obesity is a disease,” adding, ”If a person with a BMI of 35 or 40 or more is socially disadvantaged due to obesity, it is necessary to consider providing some support through insurance.” “Although the treatments are also expensive in the U.S., if you consider the cost of procedures and hospitalization due to cardiovascular diseases, papers that show that treatments like Wegovy are rather cost-effective,” said Professor Yoon.

 

”I expect prescriptions to gradually increase in Korea, and if there is no cost hurdle, it will likely be used without limitation within the given indications.” In the end, the will of pharmaceutical companies in attempting reimbursement will be important to resolve the cost issue.

 

In this regard, Novo Nordisk is considering mid- to long-term plans to strengthen access.

 

“We understand that it is necessary to expand access to therapeutics, but this is something that needs to be discussed extensively,” said Ju Ok Lim, head of Medical Affairs at Novo Nordisk.

 

”It requires mid- to long-term discussion, but we are in the beginning stages of the process and are exploring various ways to expand access.”